雌性激素减少导致尿路微生态失调及其与绝经后尿路感染的关系

Urinary tract infection (UTI) has been proved to be one of the most common infectious disease and also we have demonstracted UTI was one of the most common complications in urological diseases ,such as acute urinary retention and othotopic ileal bladder substitution surgery data published on “Braz J Med Biol Res ” and “Urol Oncol”. Meanwhile, menopause has long been considered to be a predisposing factor for UTI. Nevertheless, the mechanisms of postmenopausal UTI are far from clear. Based on our preliminary data that lack of estrogen and progesterone brought a a new urine microecology and might easier cause a dysbiosis, we supposed that these changes should be an important factor leading to postmenopausal UTI and try to know further: 1. The changes of postmenopausal urinary tract microecology on rats or patients and the relationship with estrogenand progesterone; 2. The role of urinary etiology in postmenopausal UTI ;3.If the hormone replacement therapy (HRT) could regulate the microbiomic profiles and be efficient to prevent UTI from the postmenopausal females.

绝经后尿路感染（Urinary tract infection，UTI）易反复，难以根治，雌性激素减少被公认为是其发病、发展和影响其预后的关键因素。我们前期研究提示：绝经后，尿液微生态发生了改变，同时，绝经后UTI的发生与尿路微生态的失衡密切相关。在此基础上，本项目拟使用二代测序等微生态先进技术结合性激素和免疫因子检测的方法作以下研究：1.观察予雌性激素替代前后大鼠绝经模型尿路微生态的变化，进一步验证雌性激素影响尿路微生态；2.观察绝经后妇女尿路菌群的分布特征，研究雌性激素、尿液微生态、局部/全身免疫因子的变化和UTI四者之间的关系，阐明绝经后UTI的微生态变化及其免疫机制；3.给予绝经后UTI妇女雌性激素替代治疗并随访，探索雌性激素水平、尿液微生态及UTI复发的关系。此研究将为预防和治疗绝经后UTI提供新的微生态思路和理论依据。

绝经后尿路感染（Urinary tract infection，UTI）易反复，难以根治，雌性激素减少被公认为是其发病、发展和影响其预后的关键因素。.本项目首先通过PCR-DGGE揭示：女性绝经后，尿液微生态的结构和组成发生了改变，同时，绝经后尿路感染的发生与尿路微生态的失衡密切相关。.为进一步探索尿液微生态在绝经后女性尿路感染中的作用，本项目使用Hiseq2500等二代测序微生态先进技术结合性激素和免疫因子检测的方法作以下研究：1.观察予雌性激素替代前后大鼠绝经模型尿路微生态的变化，验证生殖激素（雌激素、孕激素、睾酮等）影响尿路微生态；2.临床观察绝经后妇女尿路菌群的分布特征，研究生殖激素、尿液微生态和UTI三者之间的关系，发现，生殖激素与尿液微生态的变化呈现相关性，阐释了绝经后UTI的微生态机制；.课题组后期进一步随访绝经后女性，研究结果提示生殖激素水平、尿液微生态及UTI复发的具有相关性，生殖激素的补充能够一定程度上恢复尿液微生态的平衡，且微生态的平衡对预防尿路感染具有一定的正向作用。此研究将为预防和治疗绝经后UTI提供新的微生态思路和理论依据。